SPARK Reading Donation Form

Are you the student's parent or legal guardian?*

How many children participated in SPARK?*

How many children are you sponsoring?*

Student 1 Name*

First Last

Student 1 - Grade/Teacher*

Student 1 - Hours Read*

Student 1 - Parent's Name (Verification of Hours Read)*

Student 1 - Donation Amount*

Student 2 Name*

First Last

Student 2 - Grade/Teacher*

Student 2 - Hours Read*

Student 2 - Parent's Name (Verification of Hours Read)*

Student 2 - Donation Amount*

Student 3 Name*

First Last

Student 3 - Grade/Teacher*

Student 3 - Hours Read*

Student 3 - Parent's Name (Verification of Hours Read)*

Student 3 - Donation Amount*

Student 4 Name*

First Last

Student 4 - Grade/Teacher*

Student 4 - Hours Read*

Student 4 - Parent's Name (Verification of Hours Read)*

Student 4 - Donation Amount*

Contact Information

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Additional Giving Options

Is this donation eligible for corporate matching?

Company Name*

Other
Bank of America
Duke Energy
Wells Fargo

Company Name*

Payment Options

Payment Options*

Check - Make checks payable to Dilworth Elementary PTA. Please include SPARK and your student's name under Memo. Mail to Dilworth Elementary - Sedgefield or Latta campus.

PayPal (Select One)*

Donate 100% - Add 3% so that 100% of the donation goes to Dilworth Elementary.
Donate 97% - I understand Paypal, Inc. will deduct 3% to cover transaction costs.

Donate 100% - Add 3% so that 100% of the donation goes to Dilworth Elementary.

Price: $0.00

Donation Total

$0.00

Captcha

To prevent spam, solve this simple math problem above.

Contact Information

Additional Giving Options

Payment Options

Quick Links